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Guide-Occupational-Dermatitis.Pdf Recommendations for the Prevention, Detection and Management of Occupational Contact Dermatitis in Health Care Settings October 2019 Public Health Ontario Public Health Ontario is a Crown corporation dedicated to protecting and promoting the health of all Ontarians and reducing inequities in health. Public Health Ontario links public health practitioners, frontline health workers and researchers to the best scientific intelligence and knowledge from around the world. Public Health Ontario provides expert scientific and technical support to government, local public health units and health care providers relating to the following: • communicable and infectious diseases • infection prevention and control • environmental and occupational health • emergency preparedness • health promotion, chronic disease and injury prevention • public health laboratory services Public Health Ontario's work also includes surveillance, epidemiology, research, professional development and knowledge services. For more information, visit publichealthontario.ca. How to cite this document: Ontario Agency for Health Protection and Promotion (Public Health Ontario). Recommendations for the prevention, detection and management of occupational dermatitis in health care settings. Toronto, ON: Queen’s Printer for Ontario; 2019. ISBN 978-1-4868-3689-5 [PDF] Public Health Ontario acknowledges the financial support of the Ontario Government. ©Queen’s Printer for Ontario, 2019 Cover photo DermNet NZ. Irritant dermatitis [Internet]. Hamilton, NZ: DermNet New Zealand; 2003 [cited 2019 Oct 3]. Original picture provided by professor Raimo Suhonen. Available from: https://www.dermnetnz.org/topics/irritant-contact-dermatitis/. Used with permission. Recommendations for the Prevention, Detection and Management of Occupational Contact Dermatitis 2019 i Acknowledgements Public Health Ontario would like to thank Dr. Maureen Cividino, chair of the occupational dermatitis in health care committee (ODHCC), as well as Dr. Linn Holness, Jeffrey Smith, Arezou Saedi and Susan Shiller, for their exceptional efforts towards the development of this document. Public Health Ontario would also like to acknowledge the contribution and expertise of the following individuals: EXTERNAL ODHCC MEMBERS Andrea Coady Drew Sousa Nurse Consultant, Infectious Diseases and Executive Director, Ontario Occupational Control Branch, Public Health Agency of Health Nurses Association Canada Shirley Wylie Dr. Linn Holness Executive Director (former), Ontario Occupational Medicine Physician, St. Occupational Health Nurses Association Michael’s Hospital Director, Centre for Research Expertise in PUBLIC HEALTH ONTARIO ODHCC MEMBERS Occupational Disease Dr. Ray Copes Dr. Sylvie Hudon Chief, Environmental and Occupational Medical Consultant, Ministry of Labour Health Nancy Johnson Dru Sahai Labour Relations Specialist, Occupational Environmental Science Specialist, Health and Safety/Workers Compensation, Environmental and Occupational Health Ontario Nurses’ Association Dr. Sonica Singhal Dr. Matthew Muller Scientist, Health Promotion, Chronic Disease Chair, Provincial Infectious Diseases Advisory and Injury Prevention Committee Medical Director, Infection Prevention and Marlyn Aryan Control, St. Michael’s Hospital Project Coordinator, Infection Prevention and Control Susan Shiller Technical Writer, Reference 54 Sandra Callery Communications Director, Infection Prevention and Control Liz Sisolak Dr. Andrea Chaplin Health and Safety Consultant, Government Evaluation Specialist, Infection Prevention and Control and Municipal Sector, Public Services Health and Safety Association Recommendations for the Prevention, Detection and Management of Occupational Contact Dermatitis 2019 ii Dr. Maureen Cividino Arezou Saedi Chair, ODHCC Research Coordinator, Infection Prevention Occupational Health and Infection Prevention and Control and Control Physician, Infection Prevention and Control Lori Schatzler Regional Infection Prevention and Control Sarah Eden Specialist, Infection Prevention and Control Regional Infection Prevention and Control Specialist, Infection Prevention and Control Jeffrey Smith Research Coordinator, Infection Prevention Reisha Fernandes and Control Research Assistant, Infection Prevention and Control Cassandra Taylor Executive Assistant, Infection Prevention and Dr. Gary Garber Control Chief, Infection Prevention and Control Eva Truong Mabel Lim Research Assistant, Infection Prevention and Program Infection Prevention and Control Control Specialist and Technical Writer, Infection Prevention and Control Debbie Valickis Regional Infection Prevention and Control Jacquelyn Quirk Specialist, Infection Prevention and Control Evaluation Specialist, Infection Prevention and Control Amy Wrobel Administrative Assistant, Infection Prevention Dr. Jennifer Robertson and Control Manager, Infection Prevention and Control Recommendations for the Prevention, Detection and Management of Occupational Contact Dermatitis 2019 iii Disclaimer This document was developed by Public Health Ontario (PHO). PHO provides scientific and technical advice to Ontario’s government, public health organizations and health care providers. PHO’s work is guided by the best available evidence at the time of publication. The application and use of this document are the responsibility of the user. PHO assumes no liability resulting from any such application or use. This document may be reproduced without permission for non-commercial purposes only and provided that appropriate credit is given to PHO. No changes and/or modifications may be made to this document without express written permission from PHO. Recommendations for the Prevention, Detection and Management of Occupational Contact Dermatitis 2019 iv Contents Glossary of Terms.......................................................................................................................................... 1 Preamble ....................................................................................................................................................... 7 About This Document ............................................................................................................................... 7 Scope ......................................................................................................................................................... 8 How and When to Use This Document ..................................................................................................... 9 Document Limitations ............................................................................................................................. 10 Applicable Legislation ............................................................................................................................. 10 Health Equity Considerations .................................................................................................................. 12 Methodology Overview .............................................................................................................................. 14 Systematic Literature Search .................................................................................................................. 14 Review of Abstracts ................................................................................................................................ 14 Critical Appraisal of Papers ..................................................................................................................... 15 Evidence Tables ....................................................................................................................................... 15 Evidence Statements and Recommendations ........................................................................................ 15 Summary of Research Questions ................................................................................................................ 16 Summary of Recommendations.................................................................................................................. 19 Grading of Recommendations ................................................................................................................ 19 Final Recommendations.......................................................................................................................... 20 1. Background ......................................................................................................................................... 28 1.1 Structure and Function of the Skin ............................................................................................. 28 1.2 Occupational Contact Dermatitis ................................................................................................ 29 1.2.1 Irritant Contact Dermatitis .................................................................................................. 29 1.2.2 Allergic Contact Dermatitis ................................................................................................. 30 1.2.3 Occupational Contact Urticaria ........................................................................................... 33 1.3 Prevalence and Incidence ........................................................................................................... 33 1.4 Workers at Risk ..........................................................................................................................
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